Of Sinners and Saints

***DISCLAIMER*** What follows is a fictional account of a similar situation that I found myself in. No names are accurate and any actual addresses are purely coincidental.

It’s 0325 am, and I have just gotten to sleep during one of the busiest shifts of my career. I’m 7 charts down, not counting the ones I’ve finished, and I can’t think for another moment to write another sentence. My body is tired, my soul is tired, and these people are most certainly trying to kill me. Sure enough, just when I’m out like a light, tones pierce the darkness and I sit bolt upright. The radio comes to life with dispatch information, “…Medic 22, 40 year old male. He is unresponsive, unsure if breathing, possible overdose, 74725 South Coriander Drive. Reporting party is uncertain what the patient has taken. Time out, 0330.”.

I let out a loud sigh and a few expletives, “This is the SAME MOTHERFUCKER I’ve had twice this week!! Jerry the FUCKING junkie…this is pointless.”, I vent aloud as I head for the bay and get into the passenger seat of the ambulance, slamming my door as I do. My EMT is there shortly thereafter and before I know it, our sirens wail as our lights rip through the dark, early morning sky. The red and blue reflections in the windows of buildings illuminate mannequins, ghosts like me…but unlike me, they are blissfully unaware and unbothered. “Wake me up when we get there.”, I sleepily tell my partner, who merely grunts in agreement. Poor Dani has been through it as well, and had to put up with my bullshit long enough. I sense she’s fed up with my agitation.

We pull up on scene and are immediately greeted by the patient’s frantic girlfriend who gives us the info we already know. “I woke up and found him like this. He’s high again. He uses heroin and I think he may have actually died this time.”. I assure her we’re here to help as I pull the stretcher out of it’s mount on the ambulance, scoffing in my mind that junkies are like cockroaches and will never die. We get in the door and sure enough, there’s Jerry on the living room floor, guppy breathing, and Smurf blue.

“Put an oral airway in and start bagging him”, I grumble to a firefighter who has arrived on scene in his personal vehicle to assist, more tersely than I intended to. “Once every 6 seconds or so.”. Dani hands me an IV kit and grabs a pre-filled syringe of Narcan and aspirates it, preparing to hand it to me. I tie on my tourniquet, find a juicy AC vein and contemplate starting an IV in his neck just for getting me out of bed. Nevertheless, I sink a 20, lock it, and flush it. Next comes the Narcan and I give him a half-milligram of the 2 mL syringe, flushing it so that it enters his circulation quickly, rolling him on his left side in case he vomits.

After about a minute or so of bagging, Jerry gasps loudly and sits bolt upright, ripping the mask off his face and coughing out the oral airway that was placed. “What the hell happened?!”, he demands, eyes open and in shock that we’re there. “Well, Jerry,” I begin, “it seems your girlfriend woke up this morning and found you half-dead on the floor. Mind telling me what you took?”. He, as usual, replies that he “ain’t took nothin’”, and I roll my eyes in disgust. I ask if he would like to be transported to the hospital, to which he promptly replies he would like me to get the fuck out of his house. “Fine by me”, I mumble as I give him the usual spiel about how Narcan is short acting and sometimes, the drugs outlast the Narcan (which works by blocking the receptor sites for opioids), at which time he could become unconscious and could die. Of course, he understands and hastily signs a refusal. With that, we load our equipment back into the ambulance, thanking the firefighter for his help before heading back. “Medic 22 dispatch, we’re in service with a refusal Against Medical Advice”.

“How long ‘til we’re back? Wanna take bets?”, I ask my partner. She casts a glare across the ambulance at me, shakes her head, and says, “You know? I remember when you truly cared for these patients. Now? I’m not so sure.”. I just sit there in the silence, shocked at what I’d just heard. Is that me now? Have I become so jaded? I’m left to ponder this as we get back and restock, then drift back off to sleep, hopefully, that was the last one.

Tones again cut my nap short and I check my watch…0630. Oh well, better than nothing, I think to myself. “Medic 22, 72 year old female, reporting chest pain that awoke her from sleep. Time out, 0632”. I don’t mind these calls so much, so I’m in a better mood by the time we call en route. The drive is short and soon thereafter we are at the patient’s bedside. She’s an elderly female named Elaine, short blue hair and a baby blue nightgown, sitting on the edge of the bed. She looks tired and worn out, but smiles sweetly when we walk into the room.

I smile and greet her, “Good morning, ma’am, I’m J, a Paramedic. What seems to be the problem.” She tells me that she woke up from sleep with chest pain that she describes as “excruciating” as well as pain in her jaw. She denies any nausea and vomiting and has no cardiac history, but does tell us that she had some spicy food for dinner and thinks it might be indigestion. “Tell ya what, Mrs. Elaine, why don’t we get an ECG and check out your heart anyway and take you to the hospital just to be safe. Would you be okay with that?”, she agrees and I give her some aspirin to chew up while we assist her to the stretcher. My partner informs her that we have to lift her shirt and bra to apply the electrodes to get a good reading, and she nods in agreement. “Mrs. Elaine, do you have meds I can look at and write down?”, I ask, and she points me to the kitchen. I walk down the hall and can’t help but glance at the photos on her wall. Family photos, a husband and a young boy who looks vaguely familiar for some strange reason. The same boy, a little older, in football pads with his parents by his side, graduation photos, the American dream lining the wall. I write down the med list and head back to the patient.

My partner hands me the ECG strip, which I begin to read as I gather a further medical history, Dani writing them down as Mrs. Elaine speaks. The strip shows nothing of concern; the most beautiful Sinus Rhythm I’ve probably ever seen. “Well, ma'am, your heart looks good, so I don’t believe you’re having a heart attack. I still want to take you to the hospital just to be sure.”, and she agrees. We get in the back of the ambulance and I get an IV quickly, and the patient reports she is having no more pain. “I’ll have us there shortly, Mrs. Elaine”, Dani informs her as she shuts the back doors and I feel the ambulance inch slowly forward down the driveway and turn onto the street. Settling onto the bench seat for the 10 minute or so drive, I call my report to the hospital quickly and make small talk with Mrs. Elaine.

“So, tell me about your family.”, I say just to make her more comfortable. She tells me of her husband, who passed away about ten years ago. He was a military and “the most beautiful man I ever saw”, she tells me. She tells me about her son, who was a straight-A student, athlete, and later a foreman on a construction crew that built some of the nicest houses in the area. “You wouldn’t know it by looking at him now. His name is Jerry, and he was always very talented at everything he did. That is, until he got hurt”., she says, and the name hits me like a ton of bricks. The familiar boy in the family photo? That’s Jerry. The very same junkie I ran on not three hours ago. Curiously, I implore her for more of the story. She continues, telling me that he fell off a roof and fractured several vertebrae and was almost paralyzed, but recovered well. However, he became addicted to painkillers, and when those ran out, he sought other things. “He’s on heroin now. Sad to see what he’s become, but you know? He still comes to see me every day, and he’ll always be my baby boy. I pray every day he’ll get better. That’s what a mother does, you know.”.

I couldn’t believe what I’d just heard. We arrived at the hospital and took her inside, giving our report to the nurse. She signs my chart, as does the patient, and I smile as I bid her farewell. “Mrs. Elaine, thank you for letting me take care of you and for the great conversation. Take care!”. She waves and smiles, and I walk back out to the ambulance, still in a state of shock…and suddenly feeling like a real heel. “Everything okay?”, Dani asks as I hop in the passenger seat. I can’t think of what to say, so I give a thumbs up and we start the drive back. The sun has broken through the clouds by now and my shift is about at it’s end. I need to work on charts, but I’m lost in my thoughts as I stare out the window, ashamed of myself. That same junkie…er, MAN that I had been mad at for inconveniencing me? He was somebody’s BABY. Even to this day, even in light of his present situation. Truly, it wasn’t even his fault, but I was so blinded by my own inconvenience and anger that I didn’t even consider it.

It also occurred to me that Dani was right. I had lost the one thing that a Paramedic should never lose—empathy. The ability to actually care. As we entered the neighborhood in which our station sat, I had a fleeting thought, and I try to keep that in the back of my mind even today. We are all just one moment away…one injury, one illness, one slip, stumble, or fall away from a similar fate. It could be me, or you, or my family in that same situation, and how would I feel if the people who were supposed to be caring for them treated them the way I had treated Mrs. Elaine’s son? That junkie that we pass and judge? That’s someone’s child. That homeless person? They’re loved by SOMEONE. Most of all, we are all human. Inherently, we want similar things. A fruitful life. To be loved, to enjoy life, and most of all, to be happy. If we lose that humanity, what do we have left? The world could use more kindness…and it starts with me.